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General NPI Number Information
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NPI Number | 1427180645
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Entity Type | Organization
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Legal Business Name | FLORIDA DERMATOLOGIC SURGERY & AESTHETICS INSTITUTE PA
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 11950 COUNTY ROAD 101 SUITE 203
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City | THE VILLAGES
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State | FL
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Zip | 32162-9332
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Country | US
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Telephone | 352-430-2580
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Fax | 352-430-2651
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Provider Business Mailing Address
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Address Line | 11950 COUNTY ROAD 101 SUITE 203
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City | THE VILLAGES
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State | FL
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Zip | 32162-9332
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Country | US
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Telephone | 352-430-2580
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Fax | 352-430-2651
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Authorized Official
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Title or Position | OWNER
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Name | ASHRAF M HASSANEIN
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Credential | MD
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Telephone | 352-430-2580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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